Obstetrics

Cesarean section: indications, preparation and recovery

Written by med

Caesarean section is one of the few medical procedures that has preserved its name since time immemorial. It is associated with the name of Gaius Julius Caesar (“Caesar” — “the king”), which, as they say, was born that way. We will not dispute the truth of this fact, especially as that is unlikely ever to confirm.

The content of the article

  • Indications for cesarean section
  • Indications for planned cesarean section
  • Indications for emergency cesarean section
  • Contraindications for cesarean section
  • Preparing for cesarean section
  • How is a cesarean section?
  • Recovery after cesarean section
  • Possible complications after cesarean section:
  • Related video: “Caesarean section”

In modern medicine, a cesarean section is a surgical operation to remove the fetus from the womb by excision of the abdominal wall and uterus. Why go around when there is a direct path? The fact that natural childbirth in some cases can carry a risk for both the mother and the child. So the output is one: “cesaret”.

Preparing for a cesarean cechenochilus such operations is about 15% of the total number of births. To perform a caesarean section not one desire of the mother, it is performed for certain indications. First births through cesarean section determine this mechanism and the subsequent delivery, although we can not exclude the natural way, here are all individually. Age (over 30 years) “parvarotti” are the main “customers” of surgeons in the maternity wards. It should be noted that the risk to mothers for caesarean section are naturally higher than in natural childbirth.

As for babies, emerging into the light “roundabout” way, they are not the least bit different from children that have passed fire, water and… of the fallopian tube.

Indications for cesarean section

Caesarean can be both planned and emergency, force majeure. The latter is carried out at a occur during childbirth threat to the life or health of the mother or the child.

Indications for planned cesarean section

  • placenta previa with a concomitant bleeding;
  • incorrect orientation of the fetus in the uterus (pelvic part of the fruit facing the exit from the uterus (breech presentation) or the fetus is across the uterus);
  • anatomical narrow pelvis mothers combined with a large size of the fetus;
  • multiple pregnancy;
  • rhesus-conflict mother and fetus;
  • the presence of concomitant diseases and pathological conditions (eclampsia, diabetes, hypertension, heart disease, kidney disease, asthma, high degree of myopia);
  • tumors of the soft birth canal (fallopian tubes, uterus, vagina);
  • in vitro fertilization (IVF);
  • the short length of the umbilical cord;
  • prior surgery on the uterus (when the bad condition of scar).

Indications for emergency cesarean section

  • premature detachment of normally located placenta;
  • violations of labor (weak, strong or discoordinated labor activity);
  • acute fetal hypoxia with disturbances of the heartbeat;
  • early discharge of amniotic fluid in the absence of response of the uterus to the stimulation;
  • prolapse of the umbilical cord;
  • the threat of uterine rupture.

Contraindications for cesarean section

  • infectious diseases of the genital tract;
  • purulent inflammation of the abdominal wall;
  • inflammation of the foetal membranes (amnionic);
  • deep prematurity of fetus;
  • severe malformations of the fetus incompatible with life or intrauterine fetal death.

Preparing for cesarean section In a planned caesarean section a pregnant woman has to be hospitalized earlier than in normal birth: this occurs in one to two weeks before the “Hour X” (i.e., 38-39 week of pregnancy). And then begins the process of preparation worse than the astronauts. Take the General and biochemical blood analysis, urine analysis, doing vaginal, fetal ultrasound, cardiotocography (registration of the cardiac rhythm of the fetus). The anesthesiologist after a thorough medical history and required examinations is determined by the anesthesia and the preparations for it.

The night before the operation it is possible to use sedatives for a full normal sleep. On the day of surgery to the woman in labor not to eat or drink. With hygienic purpose needed a shower. Directly before the operation the bladder is found, the catheter, the legs covered with a bandage, apply anesthesia (most commonly an epidural) — and in a good way.

How is a cesarean section?

A cesarean Secreatary for access to the uterus of the new mother opened the abdominal cavity. This can be longitudinal or cross-section, it is all about the surgeon. A cut is then made of the uterine wall, the edges of which overlap the clips. The last barrier to the scalpel of the surgeon — SAC, from which is extracted the fruit itself. Then you need to excise the umbilical cord and pass the little screaming lump midwife. Any bleeding warn the patient to the introduction of oxytocin or metilergometrina that increases the tone of smooth muscle of the carcass of the uterus. The umbilical cord from the uterus in the sky, the so-called afterbirth — the placenta with the remains of the fetal membranes. That’s it: you can sew, impose aseptic bandage and congratulate the new mother.

Recovery after cesarean section

The scar after cesarean secenekli all ended well (i.e. no complications), then the next day you can sit down and carefully walk around the ward. And to feed your child can already two hours after surgery. The stitches will be out in a week, after which the young mother finally goes home. But this does not mean that operations can be forgotten. Yes, and a fresh scar will not allow to do it. Be careful: in the first 2-3 months not to lift anything heavier than their own child, and it should not take bending in three deaths, from a low cot or stroller. If within one month will be felt nagging pain in the lower abdomen, nothing to worry about: the pain associated with the healing of scar and uterine contractions. As a rule, the seam heals without any problems. Only occasionally is inflammation that requires an immediate visit to the surgeon. Cause for alarm should also be a sharp pain, rise of temperature or profuse bloody vaginal discharge. In such cases, you must immediately go to the antenatal clinic.

As for the gastronomic aspect, the first day after surgery should be without food because the intestines had not yet regained his job. Later you can eat cereal, low-fat soups, tea, yogurt. On 5th days of the transition to the usual diet.

Possible complications after cesarean section:

Details about the complications during and after cesarean section read in this article.

  • bleeding;
  • inflammation of the peritoneum due to damage to wall of the bladder and get urine on her.
  • inflammation of muscle (biometric) or mucous membrane (endometritis) of the endometrium in the case of inclusion in it of the infection;
  • blood clots, thrombus detachment and obstruction of the vessel;
  • adhesions (uterus, intestine, peritoneum);
  • anemia (eliminated by iron supplementation);
  • nedoshivina of the uterine scar, resulting in the following pregnancy, it can diverge.

In conclusion, I want to answer one of the most pressing issues for women undergoing cesarean section: when it will be possible next time to give birth? Not earlier than 2-3 years after surgery. And abortion in this period is also undesirable. There is a risk of perforation of the uterus at the incision. Therefore, you should pay more attention to the issue of contraception.

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